Optimization of balloon obstruction for simulating equivalent pressure drop in physiological stenoses

The study of hemodynamics in an animal model simulating coronary stenosis has been limited due to the lack of a safe, accurate and reliable technique for creating an artificial stenosis. Creating artificial stenosis using occluders in an open-chest procedure has often caused myocardial infarction (MI) or severe injury to the vessel resulting in high failure rates. To minimize these issues, closed-chest procedures with internal balloon obstruction are often used to create an artificial stenosis. However, the hemodynamics in a blood vessel with internal balloon obstruction versus a physiological stenosis has not been compared. Hence, the aim of this research is to develop a relationship to predict the balloon obstruction equivalent to that of a physiological stenosis. The pressure drop in a balloon obstruction was evaluated and compared with that in a physiological stenosis. It was observed that the flow characteristics in balloon obstructions are more viscous dominated, whereas those in physiological stenoses are momentum dominated. Balloon radius was iteratively varied using a Design of Experiments (DOE) based optimization method to obtain a pressure drop equal to that of a physiological stenosis at mean hyperemic flow rates. A linear relation was obtained to predict equivalent balloon obstruction for a physiological stenosis. Further, the details were verified with our in vivo (animal) study data.